Health Update

Suicide-Prevention Plan Envisions Larger Role for Schools:
Noting that suicides outpace murders in the United States, the U.S.
surgeon general has crafted a national suicide-prevention strategy that
calls on all sectors of society—including the education
community—to work together to improve the grim picture.

In a report issued this month, Dr. David Satcher emphasizes the need
for greater awareness of the problem, earlier intervention and better
support to help people who are at risk of committing suicide. Suicide
takes more than 30,000 lives a year, making it the nation's
eighth-leading cause of death.

The report outlines a key role for schools, both in ensuring their
teachers are better trained to recognize a suicidal young person and in
presenting evidence-based suicide-prevention programs. Federal
statistics show that people age 19 or younger account for about 9
percent of U.S. suicides. Many experts have faulted schools' prevention
efforts, though some programs get high marks. ("Complex Set of Ills Spurs Rising
Teen Suicide Rate," April 12 and "Suicide: Many Schools Fall Short
on Prevention," April 19, 2000.) "Only recently have the knowledge
and tools become available to approach suicide as a preventable problem
with realistic opportunities to save many lives," Dr. Satcher said in
releasing the report May 2. "The public-health approach laid out in
this national strategy represents a rational and organized way to
marshal prevention efforts and ensure that they are effective."

Among the recommendations in the report are finding ways to reduce
the stigma associated with seeking counseling, promoting effective
clinical practices, and stepping up efforts to reduce access to lethal
means of self-injury.

Recognizing Signs of Autism: The American Academy of
Pediatrics has issued new guidelines to help pediatricians spot early
signs of autism.

Diagnosing autism is difficult because it is a collection of
brain-development disorders. As a result, doctors must look for the
presence or absence of a group of symptoms, relying on parents'
anecdotes, clinical judgment, and the ability to recognize autistic
behaviors, the academy said in a statement accompanying release of the
guidelines, published in the May issue of Pediatrics.

The AAP recommends that doctors listen carefully to parents,
especially when they voice concerns about their child's language and
social development, and that, if possible, doctors use screening tools
designed to help diagnose autism. Early diagnosis and intervention are
shown to create better outcomes in autistic patients, academy officials
said.

The group also tried to dispel fears of a link between autism and
the measles-mumps-rubella childhood immunization. It said there is no
scientific evidence that the vaccine causes autism.

Children who are autistic have some impairment in reciprocal social
interaction and communication. They also engage in repetitive behaviors
and a limited range of interests and activities. Experts believe that
as many as two in 1,000 children are autistic.("Sharp Rise Seen in Identification
of Autistic Pupils," October 20, 1999.)

The guidelines, "Technical Report: The Pediatrician's Role in the
Diagnosis and Management of Autistic Spectrum Disorder," are available
online at www.aap.org/policy/re060018.html
.

Head Lice Policies: School policies that prohibit children
from attending school when they have "nits"—which are lice
eggs—but no actual head lice may be too restrictive, a report
suggests.

The study, published in this month's issue of Pediatrics,
notes that the epidemiology of head-lice infestation is not well
understood, and that many schools treat all children with nits as
though they were contagious.

Researchers examined 1,729 students in two Atlanta elementary
schools and found 28 with lice, and 63 who had nits but no lice. Of the
63 nits-only children, 50 had follow-up screening two weeks later, and
only nine—18 percent—of those were found to have become
infested with lice, the study found.

The researchers recommend that children who have only nits be
examined repeatedly, and treated if they have crawling lice, but say
that excluding them from school is "likely excessive."

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